Objective To investigate the influences of different factors on postpartum pelvic floor muscle injury, and provide clinical evidence to the early prevention of pelvic floor dysfunction (PFD). Methods A total of 65 630 women, who participated the postpartum pelvic floor function screening in Tianjin, from December 2011 to December 2014 were selected in this study. The uniform detect methods was used in this study. The analysis based on the PFD was diagnosed by physi?cians of Women’s and Children’s Health Center in each district. The influences of different factors on postpartum pelvic floor muscle were analyzed. Results There were 19 452 (29.6%) women suffering from postpartum pelvic floor muscle inju?ry, with the abnormal rate 29.6%, which was higher in rural areas than that in urban areas (33.9%vs 27.8%). The abnormal rate was higher in women with junior middle education or below (34.1%) than that in women with senior middle or polytech?nic schooling (30.4%), and women with college or higher education (27.7%). There was a higher abnormal rate in women with vaginal surgery delivery (40.8%) than that in women with natural delivery (32.5%) and women with caesarean section (27.2%). The muscle abnormal rate was higher in women having given two or more than two times of deliveries (34.6% , 31.5%) than those having initial delivery (29.1%). Multiple factor analyses showed that city residency, higher education and less delivery times were protecting factors for postpartum pelvic floor muscle while vaginal surgery was a risk factor for post?partum pelvic floor muscle. Conclusion There is a high incidence of postpartum pelvic floor muscle injury in the region of Tianjin. Analyzing the risk factors and strengthening the management of pelvic floor muscle injury by early prevention or ear?ly treatment would help to reduce the incidence of PFD effectively during pre-pregnancy and perinatal periods.

Objective To describe the condition of depression of the undergraduate nursing students in practice,and compare the differences of depression between male and female nursing students.Methods Using the Beck Depression Inventory (BDI) to investigate the undergraduate nursing students who were practicing in the Affiliated Hospital of Sun Yat-sen University from July 2011 to June 2012 and analyze the condition and gender-related differences of depression.Results The occurrence of depression was high in the undergraduate practical nurses(37.2％).The occurrence of depression in the male (41.2％)undergraduate practical nurses was higher than that in the female (34.6％) undergraduate practical nurses.The occurrence of depression was mostly light depression(16.3％) and middle depression (20.9％),no serious depression occurred.Conclusions The higher occurrence of depression in the undergraduate practical nurses and the gender-related differences signify the importance of psychological problems.

Objective To analyze the related factors of nursing risk in department of nephrology and to explore strategies of risk management.Methods Risk management was implemented to 39 nurses in department of nephrology of our hospital.The KAP scores,the incidence of nursing risk events,nursing complaints and patients' satisfaction degree before and after the implementation of nursing risk management were compared.Results After the implementation of nursing risk management,nurses' KAP score was significantly higher; the incidence of nursing risk events and complaints significantly reduced; patients' satisfaction degree to nursing were significantly higher compared with those before the implementation.Conclusions The implementation of nursing risk management can effectively improve the quality of nursing and reduce the incidence of nursing risk events.

Objective: To investigate β2 adrenergic receptor (β2-AR) gene polymorphism, Arg16Gly, Gln27Glu and essential hypertension (EH) occurrence in Tibetan population living at high altitude area. Methods: Our research included in 2 groups: EH group, n=385 patients and Control group,n=297 normal healthy subjects. β2-AR polymorphisms of Arg16Gly and Gln27Glu were detected by Snapshot mini-sequencing technique and their frequencies were compared between 2 groups and male, female genders. Results: The genotype and allele frequency distributions of Arg16Gly and Gln27G1u were similar between 2 groups, P>0.05; there were no signiifcant differences between male and female genders,P>0.05. Conclusion: No obvious relationship was found between β2-AR gene polymorphism (Arg16Gly, Gln27Glu) and EH occurrence in Tibetan population living at high altitude area.

Objective To evaluate the role and mechanism of ifenprodil, which is the selective antagonist of N-methyl-D-aspartic acid subtype receptor NR2B, in soflurane-induced cognitive dysfunction in neonatal rats.Methods Twenty-eight 7-day-old Sprague Dawley rats, weighing 15-18 g, were randomly divided into 4 groups (n=7 each): control group (group C), ifenprodil group (group I), sevoflurane group (group S) and ifenprodil+sevoflurane group (group IS).Normal saline 0.2 ml was injected intraperitoneally in group C.Specific NR2B receptor antagonist ifenprodil 5 mg/kg was injected intraperitoneally at the corresponding time points in group I.Normal saline 0.2 ml was injected intraperitoneally and 2.0% sevoflurane was inhaled for 4 h in group S.Ifenprodil 5 mg/kg was injected intraperitoneally 2 h before sevoflurance inhalation, and 2.0% sevoflurance was inhaled for 4 h in group IS.The rats were then sacrificed 3 weeks after administration, their brains were immediately removed and hippocampal slices were prepared for electrophyisological experiments.The value of population spike amplitude (PSA) and long-term potentiation (LTP) were measured every 10 minutes.Induced LTP was recorded.Results Compared with group C, the values of PSA and rates of induced LTP were significantly decreased in group S (P＜0.01).The values of PSA and rates of induced LTP were significantly increased in group IS than those in group S (P＜0.01).Conclusion NR2B receptor is involved in sevoflurance-induced cognitive dysfunction in the neonatal rats.Pretreatment with ifenprodil 5.0 mg/kg can improve the neurotoxicity and protect the brain.

Objective To explore abnormalities in functional connectivity of the affective network (AN) in relapse of major depressive disorder (MDD) after antidepressant treatment combined with resting state functional connectivity analysis.Methods Eleven recurrent MDD subjects after treatment,seventeen non recurrent MDD subjects after treatment and seventy-two healthy controls underwent fMRI scan.The amygdala,the pallidum,the insular cortex and the anterior cingulate cortex of the AN were selected as the template.Group independent component analysis (ICA) was performed to decompose the fMRI images into spatially independent components and the independent component which fit this template best was selected as AN.Two-sample t-tests were performed to investigate the changes in functional connectivity of the AN.Finally,the right amygdala and the medial prefrontal cortex were defined as seed regions.Results Compared with healthy control subjects and non-recurrent MDD group,recurrent MDD group showed significantly increased functional connectivity in the right amygdala in AN(P＜0.001).Meanwhile,the functional connectivity between the right amygdala and the medial prefrontal cortex was significantly decreased in recurrent MDD group(P ＜0.05).Conclusion Abnormal resting-state functional connectivity of the right amygdala after antidepressant treatment in MDD was found,suggesting that altered amygdala functional connectivity may serve as a predicator of relapse of the MDD.

Objective To explore the effects of abnormal effective connectivity within the default mode network (DMN)in relapsed patients with major depressive disorder.Methods Resting-state functional magnetic resonance imaging (rs-fMRI)data were collected from 21 patients of first-episode depression and 16 patients with relapsed depression,and 37 matched healthy controls.The effective connectivity within the DMN was investigated with spectral dynamic causal modeling (spDCM)method.Results spDCM analysis showed that the effective connections from left parietal cortex(LPC)to right parietal cortex(RPC)and medial frontal cortex(mPFC)were significantly decreased,while the connection from posterior cingulate cortex(PCC)to mPFC was increased in patients of first episode depression compared to healthy controls.Furthermore,the connectivity between mPFC and LPC were enhanced in patients with recurrent depression compared withhealthy control subjects,as well as PCC.Meanwhile,the connectivity between mPFC and PCC was enhanced in patients with relapse depression compared with patients of first episode depression.Conclusion Both first-episode and relapsed patients demonstrated abnormal effective connectivity of LPC,implicating that abnormal LPC connectivity may be associated with the neural substrates of depression.In contrast,the patients with relapsed depression showed aberrant connectivity with the mPFC,suggesting that abnormal effective connectivity of the mPFC may play an important role in the relapse of depression.

OBJECTIVETo explore the prevalence, awareness, treatment and control rates of hypertension among Tibetan monks in Gannan Tibetan Autonomous Prefecture of Gansu Province, and to analyze risk factors of hypertension in this population.

METHODSA total of 984 (aged 18 and over) Tibetan monks in Gannan Tibetan Autonomous Prefecture of Gansu Province were included with cluster sampling method from March to June, 2014. General information was obtained by questionnaire and blood pressure was measured. Multivariate logistic regression analysis was applied to analyze the risk factors of blood pressure.

RESULTSPrevalence of hypertension in this population was 19.3% (190/984), and standardized prevalence rate was 21.7%. The prevalence of hypertension were 16.3% (82/502), 21.0% (60/286) and 24.5% (48/196), and standardized prevalence rate was 17.8%, 22.1% and 26.6% among Tibetan monks aged 18-39, 40-59 and ≥60 years, respectively. Rates of awareness, treatment and control of hypertension in Tibetan monks were 9.5% (18/984), 4.2% (8/984)and 1.6% (3/984), respectively. Multivariate logistic regression analysis showed that age, body mass index and family history of hypertension were independent risk factors of hypertension in this population (P<0.01 or 0.05).

CONCLUSIONSPrevalence, awareness, treatment and control rates of hypertension among Tibetan monks in Gannan Tibetan Autonomous Prefecture of Gansu Province are relatively low. Age, body mass index and family history of hypertension are risk factors of hypertension in this population.

Blood Pressure ; Body Mass Index ; Humans ; Hypertension ; epidemiology ; Monks ; Prevalence ; Reference Standards ; Risk Factors ; Surveys and Questionnaires

Objective To observe the expression of autophagy-related genes and proteins in the smooth bladder muscle of rats after spinal cord injury (SPI).Methods Twenty-four male Wistar rats were randomly and evenly divided into a model group and a control group.The model group had SPI induced using the modified Allen's method,while the control group was only given laminectomy.Six hours after the operation,the Basso Beattle Bresnahan (BBB) locomotor rating scale was used to evaluate the rats' hindlimb locomotor function.Nissl staining was used to observe the morphological changes in their spinal cords,while Western blotting and immunofluorescence staining were employed to assess the expression of microtubule-associated protein 1 light chain 3 (LC3) and protein 62 (P62).The expression of autography gene Beclin1 mRNA was determined using a reverse transcription polymerase chain reaction (RT-PCR).Results The average BBB score in the model group was significantly lower than in the control group.After Nissl's staining,a decreased number of neurons and Nissl bodies was observed.Western blotting showed that the expression of LC3-Ⅱ had increased significantly and that of P62 had decreased significantly in the model group compared with the control group.The immunofluorescence staining showed LC3 and P62 dots in the bladders' smooth muscle cells.RT-PCR detected significantly higher LC3 and Beclinl mRNA levels in the model group than in the control group;in contrast the average P62 mRNA level was significantly lower.Conclusions Autophagy was activated in rats' bladder muscles after SPI.That may be related to the pathogenesis of a neurogenic bladder after spinal cord injury.

Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT（HRCT） in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of （42±12） years and hospital stay of （19±5） days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.